Belen, Jack G

Belen, Jack G is an individual health care provider with primary practice located at 20307 West 12 Mile Road Suite 102, Southfield MI 48076. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Belen, Jack G can be contacted via phone (248) 356-6661.

Contact Information

Primary practice address
20307 West 12 Mile Road Suite 102 Southfield MI 48076
Phone: (248) 356-6661
Fax: (248) 356-6619
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X JB042374 Michigan

Profile Details

NPI number 1376565994
LBN Legal business name Belen, Jack G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376565994 NPPES
Michigan MEDICAID 1552582

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